Magnetic Resonance Evaluation of Pelvic Mass Lesions in Females with Histopathological Correlation: An Institutional Experience

Abstract

Introduction Magnetic resonance imaging (MRI) is often used in the detection and staging of large pelvic masses. Many large masses in the female pelvis arise from the reproductive organs. These pelvic masses most commonly arise from the uterus, cervix, ovaries, and fallopian tubes. Objective This study was aimed to assess the role of MRI in female pelvic mass lesions. Also, it presents a pictorial review of MRI images of such pelvic masses. Materials and Methods This study was conducted on 50 female patients with clinically suspected pelvic masses at physical examination and referred for MRI at a tertiary care hospital over a 2-year period between July 2017 and June 2019. Results Most common lesions evaluated on imaging were benign uterine lesions (15 cases, 34.09%), benign adnexal lesions (13 cases, 29.54%), malignant adnexal (10 cases, 22.73%), malignant uterine cervical lesions (6 cases, 13.64%); two cases had indeterminate type lesions, two lesions proved to be normal bowel loops on MRI, and in two cases MRI could not be performed. Cystic lesions were commonly seen in adnexa (15 out 21) while solid lesions were common in uterine cervical region (18 out 23). Out of these, 14 were complex cystic adnexal masses and 10 were malignant. Uterine cervical lesions were carcinoma cervix. Better assessment with improved imaging capability was possible on MRI for invasion of surrounding structures in 10 cases, lymphadenopathy in 3 cases, ascites in 13 cases, peritoneal implant in 6 cases, encasement in 1 case, and distant metastases in 1 case. Conclusion In conclusion, pelvic mass lesions in females are more common above the age of 45 years. Adnexal masses are usually cystic, while the uterine masses are solid in texture. As the complexity and size of the cystic adnexal masses increases, there are increased chances of malignancy. Pretreatment staging and assessment of malignancy, invasion of surrounding structures, encasement, invasion of vessels or assessment of lymphadenopathy, peritoneal implant, ascites, and distant metastases are better appreciated by MRI.